Pancreatic surgery is a safe teaching model for tutoring residents in the setting of a high-volume academic hospital: a retrospective analysis of surgical and pathological outcomes
| Autor: | Salvatore Paiella, Debora Ciprani, Roberto Salvia, Massimiliano Tuveri, G. Deiro, Giuseppe Malleo, Giovanni Marchegiani, Luca Landoni, Stefano Andrianello, Luca Casetti, Alessandro Esposito, Claudio Bassi |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry General surgery Gastroenterology MEDLINE medicine.disease Active participation Pancreatic surgery Teaching hospital Pancreaticoduodenectomy Pancreatic Neoplasms Pancreatic Fistula Pancreatectomy Postoperative Complications Case selection Pancreatic fistula Retrospective analysis Medicine Humans NA business Pathological Hospitals High-Volume Retrospective Studies |
| Zdroj: | HPB : the official journal of the International Hepato Pancreato Biliary Association. 23(4) |
| ISSN: | 1477-2574 |
| Popis: | Academic hospitals must train future surgeons, but whether residents could negatively affect the outcomes of major procedures is a matter of concern. The aim of this study is to assess if pancreatic surgery is a safe teaching model.Outcomes of 1230 major pancreatic resections performed at a high-volume pancreatic teaching hospital between 2015 and 2018 were compared according to the first surgeon type, attending vs resident.Residents performed a selection of 132 (16%) pancreaticoduodenectomies (PD) and 46 (11%) distal pancreatectomies (DP). For PD, pancreatic fistula (25% vs 0, p 0.001), biliary fistula (7.1% vs 3.5%, p = 0.04) and operative time (400 vs 390 min, p 0.001) were lower for residents but post-pancreatectomy hemorrhage was higher (20.5% vs 13% p = 0.024). For DP, pancreatic fistula rate was lower for residents (31.7% vs 17.5% p = 0.046). There was no difference in terms of lymph nodes retrieval both for PDs and DPs, while the R1 resections were more frequent among PDs performed by attending surgeons (31.5% vs 15.7%, p = 0.023).The active participation of residents does not negatively affect outcomes of major pancreatic resections in a high-volume center. By means of case selection and continuous tutoring, pancreatic surgery represents a safe and valid teaching model. |
| Databáze: | OpenAIRE |
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